CELLULITE

Cellulite (actually called lipoesclerosis) is a disease and not just a cosmetic problem. You must always make a distinction between the localized adiposity, where fat cells are enlarged but no biochemical changes are present.

In cellulite progressive changes are observed in the tissues structure. There is a particular predisposition of the adipose tissue associated with changes in microcirculation and support tissue.

Causes:
The lipoesclerosis or fibro sclerosing edematous paniculopathy has a multiple etiology that can be classified into predisposing factors, determinant factors and aggravating factors.

• Determinant factors: include endocrine alterations (hiperestrogenism, and hypothyroidism), metabolic alterations and neurovegetative alterations.
• Predisposing factors: the genetic ones (heritage, race, sex) and constitutional ones,  obesity, circulatory disorders of the lower limbs, the use of oral contraceptives, and the presence of postural abnormalities in spine, hips and knees.
• Aggravating factors: include sedentary lifestyle, poor eating habits, constipation, smoking and stress.

Cellulite Process:

Among women of Hispanic origins that have a predisposition (the majority) after the first menstruation (menarche) begins a pattern of chronic inflammation of the fat where blood vessels (vascular endothelium) and the supporting tissue (fibroblasts) play principal roles. Over time nodules occur in the skin giving the appearance of "wells". This is the result of two opposing forces: the supporting tissue that pushes down the skin and the fluid retention joint with the adipose tissue that pushes up the skin. This process is usually seen in the hips, buttocks and thighs, over time also appear in the arms, waist and knees. It is accompanied by varicose disorders and arthrosis in the advanced periods.

If we had before us a granddaughter, her mother and grandmother that suffer this disorder we would observe the different stages described in its evolution.

Stages of the Cellulite Process

Not all women have the same presentation.

Usually has an edematous beginning and then becomes fibrosclerotic.

FIRST STAGE: EDEMA FORMACION

Indeed there is an alteration of the permeability in the wall of the capillaries, causing plasma transudation, stasis and accumulation in the interstitial tissue between the fat cells. It is a slow process. It usually begins after the first menstruation in women who are predisposed to this disease.

SECOND STAGE: ALTERATIONS IN BLOOD SUPPLY

When this phenomenon is repeated for years, causes the reaction of the defense system from the adipose cells. Under normal conditions, each adiposite is wrapped in a network of fine reticular fibers.
With edema present within these fibers, these increase in number and thickness causing the alteration in the structure of the adipose tissue and causing alterations in the blood supply.

THIRD STAGE: MICRO NODULES FORMATION

When this phenomenon is repeated for years, causes the reaction of the defense system of the adipose cells.

The fibers of the dermis and hypodermis get swollen and there is collagen degeneration. The supporting tissue that delimits the adiposites forms multiple alveoli. The circulation declines and toxins are not removed from the site. The skin is paler, and has cold temperature due to insufficient circulation.

Nodules are palpated, there is edema and the patient has a constant feeling of tired legs.

STAGE FOUR: MACRO NODULES FORMATION

When many micro nodules merge, the formation of a macro nodule begins one appreciable to palpation, movable on the underlying layer, painful to pressure. It's called "cellulite nodule”. The depressions are deeper and with larger nodules.

What is new to combat cellulite?

Cellulite usually appears after the first period and in summary is due to hormonal changes in conjunction with an alteration of local blood and lymph circulation (fluid drainage). Then the fat accumulates within the subcutaneous tissue which in turn is deposited in different layers of the skin (dermis and epidermis) forming cellulite, also known as lipodystrophy (local disruption of fat) or fibro-edema geloid (alteration of the collagen fibers of the skin).

• Subsicion: This novel methodology has its origin in the United States and is used to treat the cosmetic consequences of cellulite.

Of micro chirurgical features, its application consists on working on the tensor tissue (elastic) to cosmetically correct the defect called cellulite depression.

It is indicated in those people with cellulite in an advanced stage. Is ambulatory and performed in the doctor’s office under local anesthesia, ice or anesthetic patches in case it is necessary.
The treatment involves the use of a very fine needle whose tip has a cutting shape (similar to a scalpel) that penetrates the well making a circular motion in clockwise direction. This is how the needle will cut the tensors strips that are around. Often it is left a hematoma on the treated area that disappears within a few days.

This occurs because that blood accumulation gets reorganized to become normal fibers, allowing the leveling of the skin surface.

It is applied once for each depression covering as much affected area as possible and the treatment can take between half an hour to an hour depending on the amount of depressions.

• Subcutaneous Carboxitherapy: This novel treatment consists on the application of carbon dioxide gas into the treatment area. This gas is packed in tubes whose interior contains filters that purify their content.

To the tube a needle guide is connected at the tip of a mosquito needle (the smallest of the hypodermic needles). The application of gas in each cellulite area does not exceed two minutes and is done in the center of the subcutaneous area.

The objectives of this treatment are: to stimulate lipolysis (fat burning) and the "Bohr" effect. This consists of the union of carbon dioxide and red blood cells causing the hemoglobin to get oxygenated when the gas gets near as it loses it’s affinity for oxygen and gives it to the tissues. This fixes one of major factors that cause cellulite: poor nutrition and inadequate oxygenation of tissues.

In addition it stimulates the microcirculation improving it, not just cosmetically but at a medical level.

CELLULITE:

• Pathology of the superficial fat.
•  With changes in the micro circulation.
• 90% of Hispanic women have it.
• Do not change with diet or exercise.